Current theoretical models of generalized anxiety disorder (GAD)

Conceptual review and treatment implications

Evelyn Behar, Ilyse Dobrow DiMarco, Eric B. Hekler, Jan Mohlman, Alison M. Staples

Research output: Contribution to journalArticle

188 Citations (Scopus)

Abstract

Theoretical conceptualizations of generalized anxiety disorder (GAD) continue to undergo scrutiny and refinement. The current paper critiques five contemporary models of GAD: the Avoidance Model of Worry and GAD [Borkovec, T. D. (1994). The nature, functions, and origins of worry. In: G. Davey & F. Tallis (Eds.), Worrying: perspectives on theory assessment and treatment (pp. 5-33). Sussex, England: Wiley & Sons; Borkovec, T. D., Alcaine, O. M., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In: R. Heimberg, C. Turk, & D. Mennin (Eds.), Generalized anxiety disorder: advances in research and practice (pp. 77-108). New York, NY, US: Guilford Press]; the Intolerance of Uncertainty Model [Dugas, M. J., Letarte, H., Rheaume, J., Freeston, M. H., & Ladouceur, R. (1995). Worry and problem solving: evidence of a specific relationship. Cognitive Therapy and Research, 19, 109-120; Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791-802]; the Metacognitive Model [Wells, A. (1995). Meta-cognition and worry: a cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320]; the Emotion Dysregulation Model [Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9, 85-90]; and the Acceptance-based Model of GAD [Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive behavioral models. Clinical Psychology: Science and Practice, 9, 54-68]. Evidence in support of each model is critically reviewed, and each model's corresponding evidence-based therapeutic interventions are discussed. Generally speaking, the models share an emphasis on avoidance of internal affective experiences (i.e., thoughts, beliefs, and emotions). The models cluster into three types: cognitive models (i.e., IUM, MCM), emotional/experiential (i.e., EDM, ABM), and an integrated model (AMW). This clustering offers directions for future research and new treatment strategies.

Original languageEnglish (US)
Pages (from-to)1011-1023
Number of pages13
JournalJournal of Anxiety Disorders
Volume23
Issue number8
DOIs
StatePublished - Dec 2009
Externally publishedYes

Fingerprint

Anxiety Disorders
Theoretical Models
Clinical Psychology
Emotions
Cognitive Therapy
Mindfulness
Research
Individuality
England
Cognition
Uncertainty
Cluster Analysis
Personality

Keywords

  • Avoidance
  • Cognitive behavior therapy
  • GAD theory
  • Generalized anxiety disorder
  • Psychological theories
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Current theoretical models of generalized anxiety disorder (GAD) : Conceptual review and treatment implications. / Behar, Evelyn; DiMarco, Ilyse Dobrow; Hekler, Eric B.; Mohlman, Jan; Staples, Alison M.

In: Journal of Anxiety Disorders, Vol. 23, No. 8, 12.2009, p. 1011-1023.

Research output: Contribution to journalArticle

Behar, Evelyn ; DiMarco, Ilyse Dobrow ; Hekler, Eric B. ; Mohlman, Jan ; Staples, Alison M. / Current theoretical models of generalized anxiety disorder (GAD) : Conceptual review and treatment implications. In: Journal of Anxiety Disorders. 2009 ; Vol. 23, No. 8. pp. 1011-1023.
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